Thoracoabdominal aortic aneurysm: a totally endovascular approach with a branched stent-graft.

This video depicts a step-by-step description of a totally endovascular approach to treat a patient with thoracoabdominal aneurysm, using a branched stent-graft system. We compare the pre and post-operative computerized tomography and show 3D illustrations and real-life images of the technique.

Endovascular repair of thoracoabdominal aneurysms: results of the first 48 cases.

Background: In 2006, we began our experience with a novel technology for fully endovascular thoracoabdominal aneurysm repair, based on a custom-made, branched stent graft design. After 48 cases, we have learned and achieved substantial progress both in technical and in clinical skills. This paper describes the partial results of this ongoing experience.

Inverted limbs in fenestrated and branched endografts.

Purpose: To describe our experience with the use of custom-designed branched or fenestrated endoprostheses incorporating an inverted contralateral limb in the bifurcated component.

Methods: Retrospective analysis was performed of a prospectively maintained database of all patients undergoing endovascular aneurysm repair using modular branched or fenestrated devices at a university teaching hospital between January 2004 and February 2010. Of 102 cases, 7 male patients (mean age 69 years) were treated with modular devices that incorporated an inverted contralateral limb in the bifurcated component.

Challenging treatment of a secondary endoleak in a fenestrated endograft.

Purpose: To describe the novel use of an Amplatzer occluder device to seal a secondary endoleak arising at a scallop in a fenestrated stent-graft.

Case Report: A 67-year-old man with comorbidities precluding standard endovascular repair of a pararenal aortic aneurysm was treated with a fenestrated endoprosthesis containing one fenestration for the left renal artery and one scallop for the celiac trunk; the right renal and superior mesenteric arteries were occluded at presentation. Interval imaging at 2 years showed a proximal type I endoleak at the celiac trunk scallop associated with expansion of the aneurysm sac.